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Ye Y, Huang H, Wang L, Ding L, Mei L, Li P. Day 2 versus day 3 embryo transfer in patients with in vitro fertilization and only one zygote with two pronuclei. J Int Med Res 2024; 52:3000605241233985. [PMID: 38548469 PMCID: PMC10981240 DOI: 10.1177/03000605241233985] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Accepted: 02/02/2024] [Indexed: 04/01/2024] Open
Abstract
OBJECTIVE This study aimed to compare the pregnancy outcomes of Day 2 (D2) fresh embryo transfer and D3 fresh embryo transfer in women with only one zygote with two pronuclei (2PN). METHODS Data on 432 in vitro fertilization-embryo transfer cycles with only one 2PN zygote from January 2016 to January 2022 were retrospectively collected. A total of 302 fresh embryo transfers on D2 (n = 193) and D3 (n = 109) were analyzed, and pregnancy outcomes were compared. RESULTS The patients' characteristics were not different between D2 and D3 embryo transfer. There were no significant differences in the rates of clinical pregnancy, early abortion, or live birth between D2 and D3 embryo transfer. A multivariate logistic regression model controlling for age, the fertilization method, the number of oocytes harvested, and the number of high-quality embryos transferred showed that the live birth rate was similar between D2 and D3 embryo transfer. CONCLUSION In in vitro fertilization-embryo transfer cycles with only one 2PN zygote, D2 fresh embryo transfer may provide similar pregnancy outcomes to those of D3 embryo transfer. D2 embryo transfer may be an option because of the risk of cycle cancellation due to the absence of viable embryos on D3.
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Affiliation(s)
- Yaping Ye
- Department of Reproductive Medicine, Women and Children’s Hospital, School of Medicine, Xiamen University, Xiamen, Fujian, China
- Xiamen Key Laboratory of Reproduction and Genetics, Xiamen, Fujian, China
| | - Hui Huang
- Department of Reproductive Medicine, Women and Children’s Hospital, School of Medicine, Xiamen University, Xiamen, Fujian, China
- Xiamen Key Laboratory of Reproduction and Genetics, Xiamen, Fujian, China
| | - Longmei Wang
- Department of Reproductive Medicine, Women and Children’s Hospital, School of Medicine, Xiamen University, Xiamen, Fujian, China
- Xiamen Key Laboratory of Reproduction and Genetics, Xiamen, Fujian, China
| | - Lu Ding
- Department of Reproductive Medicine, Women and Children’s Hospital, School of Medicine, Xiamen University, Xiamen, Fujian, China
- Xiamen Key Laboratory of Reproduction and Genetics, Xiamen, Fujian, China
| | - Libin Mei
- Department of Reproductive Medicine, Women and Children’s Hospital, School of Medicine, Xiamen University, Xiamen, Fujian, China
- Xiamen Key Laboratory of Reproduction and Genetics, Xiamen, Fujian, China
| | - Ping Li
- Department of Reproductive Medicine, Women and Children’s Hospital, School of Medicine, Xiamen University, Xiamen, Fujian, China
- Xiamen Key Laboratory of Reproduction and Genetics, Xiamen, Fujian, China
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Comparison of Machine Learning Classification Techniques to Predict Implantation Success in an In Vitro Fertilization Treatment Cycle. Reprod Biomed Online 2022; 45:923-934. [DOI: 10.1016/j.rbmo.2022.06.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2021] [Revised: 06/12/2022] [Accepted: 06/20/2022] [Indexed: 11/21/2022]
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Meng Q, Xu Y, Zheng A, Li H, Ding J, Xu Y, Pu Y, Wang W, Wu H. Noninvasive embryo evaluation and selection by time-lapse monitoring vs. conventional morphologic assessment in women undergoing in vitro fertilization/intracytoplasmic sperm injection: a single-center randomized controlled study. Fertil Steril 2022; 117:1203-1212. [PMID: 35367059 DOI: 10.1016/j.fertnstert.2022.02.015] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2021] [Revised: 02/12/2022] [Accepted: 02/15/2022] [Indexed: 12/22/2022]
Abstract
OBJECTIVE To determine whether time-lapse monitoring (TLM) for cleavage-stage embryo selection improves reproductive outcomes in comparison with conventional morphological assessment (CMA) selection. DESIGN Prospective randomized controlled trial. SETTING Single academic center. PATIENTS We randomly assigned 139 women who were undergoing their first in vitro fertilization or intracytoplasmic sperm injection cycle to undergo either fresh embryo transfer or first frozen embryo transfer (FET). Only 1 cleavage-stage embryo was transferred to each participant. INTERVENTIONS The patients were randomly assigned to either the CMA or the TLM group. In the CMA group, day 2 and day 3 embryos were observed. A good-quality cleavage-stage embryo was selected for transfer or freezing in both groups. MAIN OUTCOME MEASURES The primary and secondary outcomes were the clinical pregnancy rate (CPR) and the live birth rate (LBR), respectively, after the first embryo transfer (fresh embryo transfer or FET). RESULTS The CPR and LBR were significantly lower in the TLM group than in the CMA group (CPR: 49.18% vs. 70.42%; relative risk, 0.70; 95% confidence interval [CI], 0.52-0.94; LBR: 45.90% vs. 64.79%; relative risk, 0.71; 95% CI, 0.51-0.98). The CPR with fresh embryo transfer or FET did not significantly differ between the TLM and the CMA groups (fresh embryo transfer: 44.44% vs. 70.0%, relative risk, 0.63, 95% CI, 0.39-1.03; FET: 52.94% vs. 70.73%, relative risk, 0.75, 95% CI, 0.52-1.09). There was a significant difference in the LBR with fresh embryo transfer between the TLM and the CMA groups (40.74% vs. 66.67%; relative risk, 0.61; 95% CI, 0.36-1.03). The LBRs with FET were similar in the TLM and the CMA groups (50.0% vs. 63.41%; relative risk, 0.79; 95% CI, 0.52-1.19). The rates of early spontaneous abortion and ectopic pregnancy did not differ between the TLM and the CMA groups. CONCLUSIONS Elective single cleavage-stage embryo transfer with TLM-based selection did not have any advantages over CMA when day 2 and day 3 embryo morphology was combined in young women with a good ovarian reserve. Because of these results, we conclude that TLM remains an investigational procedure for in vitro fertilization practice. CLINICAL TRIAL REGISTRATION NUMBER ChiCTR1900021981.
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Affiliation(s)
- Qingxia Meng
- Center of Reproduction and Genetics, The Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou Municipal Hospital, Gusu School, Nanjing Medical University, Suzhou, Jiangsu, People's Republic of China
| | - Yunyu Xu
- State Key Laboratory of Reproductive Medicine, Center of Reproduction and Genetics, The Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou Municipal Hospital, Gusu School, Nanjing Medical University, Suzhou, Jiangsu, People's Republic of China
| | - Aiyan Zheng
- Center of Reproduction and Genetics, The Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou Municipal Hospital, Gusu School, Nanjing Medical University, Suzhou, Jiangsu, People's Republic of China
| | - Hong Li
- Center of Reproduction and Genetics, The Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou Municipal Hospital, Gusu School, Nanjing Medical University, Suzhou, Jiangsu, People's Republic of China.
| | - Jie Ding
- Center of Reproduction and Genetics, The Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou Municipal Hospital, Gusu School, Nanjing Medical University, Suzhou, Jiangsu, People's Republic of China
| | - Yongle Xu
- Center of Reproduction and Genetics, The Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou Municipal Hospital, Gusu School, Nanjing Medical University, Suzhou, Jiangsu, People's Republic of China
| | - Yan Pu
- Center of Reproduction and Genetics, The Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou Municipal Hospital, Gusu School, Nanjing Medical University, Suzhou, Jiangsu, People's Republic of China
| | - Wei Wang
- Center of Reproduction and Genetics, The Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou Municipal Hospital, Gusu School, Nanjing Medical University, Suzhou, Jiangsu, People's Republic of China
| | - Huihua Wu
- Center of Reproduction and Genetics, The Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou Municipal Hospital, Gusu School, Nanjing Medical University, Suzhou, Jiangsu, People's Republic of China
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Benchaib M, Labrune E, Giscard d'Estaing S, Salle B, Lornage J. Shallow artificial networks with morphokinetic time‐lapse parameters coupled to
ART
data allow to predict live birth. Reprod Med Biol 2022; 21:e12486. [PMID: 36310657 PMCID: PMC9601773 DOI: 10.1002/rmb2.12486] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Revised: 08/10/2022] [Accepted: 09/08/2022] [Indexed: 12/02/2022] Open
Abstract
Purpose The purpose of this work was to construct shallow neural networks (SNN) using time‐lapse technology (TLT) from morphokinetic parameters coupled to assisted reproductive technology (ART) parameters in order to assist the choice of embryo(s) to be transferred with the highest probability of achieving a live birth (LB). Methods A retrospective observational single‐center study was performed, 654 cycles were included. Three SNN: multilayers perceptron (MLP), simple recurrent neuronal network (simple RNN) and long short term memory RNN (LSTM‐RNN) were trained with K‐fold cross‐validation to avoid sampling bias. The predictive power of SNNs was measured using performance scores as AUC (area under curve), accuracy, precision, Recall and F1 score. Results In the training data group, MLP and simple RNN provide the best performance scores; however, all AUCs were above 0.8. In the validating data group, all networks were equivalent with no performance scores difference and all AUC values were above 0.8. Conclusion Coupling morphokinetic parameters with ART parameters allows to SNNs to predict the probability of LB, and all SNNs seems to be efficient according to the performance scores. An automatic time recognition system coupled to one of these SNNs could allow a complete automation to choose the blastocyst(s) to be transferred.
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Affiliation(s)
- Mehdi Benchaib
- Hospices Civil de Lyon, HFME, Médecine de la Reproduction & Préservation de la Fertilité Féminine Bron cedex France
- UMR CNRS 5558 LBBE Villeurbanne Cedex France
- Université Lyon I, Faculté de Médecine Lyon Est Lyon France
| | - Elsa Labrune
- Hospices Civil de Lyon, HFME, Médecine de la Reproduction & Préservation de la Fertilité Féminine Bron cedex France
- Université Lyon I, Faculté de Médecine Lyon Est Lyon France
- Inserm U1208 Bron cedex France
| | - Sandrine Giscard d'Estaing
- Hospices Civil de Lyon, HFME, Médecine de la Reproduction & Préservation de la Fertilité Féminine Bron cedex France
- Inserm U1208 Bron cedex France
- Université Lyon I, Faculté de Médecine Lyon Sud Oullins cedex France
| | - Bruno Salle
- Hospices Civil de Lyon, HFME, Médecine de la Reproduction & Préservation de la Fertilité Féminine Bron cedex France
- Inserm U1208 Bron cedex France
- Université Lyon I, Faculté de Médecine Lyon Sud Oullins cedex France
| | - Jacqueline Lornage
- Hospices Civil de Lyon, HFME, Médecine de la Reproduction & Préservation de la Fertilité Féminine Bron cedex France
- Inserm U1208 Bron cedex France
- Université Lyon I, Faculté de Médecine Lyon Sud Oullins cedex France
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Nahshon C, Dirnfeld M, Koifman M, Blais I, Lahav-Baratz S. Comparison of day 2 and overnight day 3 frozen embryo transfers: A prospective randomized controlled trial. Reprod Biol 2021; 21:100565. [PMID: 34600346 DOI: 10.1016/j.repbio.2021.100565] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2021] [Revised: 09/20/2021] [Accepted: 09/21/2021] [Indexed: 11/19/2022]
Abstract
In certain patients cleavage stage embryos may be preferred. The relationship between an additional day in culture and pregnancy outcomes is not well established. We aimed to compare outcomes of day 2 versus overnight day 3 frozen embryo transfer (FET). In this randomized controlled trial, patients with day 2 cryopreserved embryos were allocated to two groups. In group A embryos were transferred on day 2, the same day of thawing. In group B embryos were transferred one day after thawing, on day 3 after overnight incubation. Out of 410 patients eligible, 92 were recruited. Finally, 72 patients participated, 39 in group A and 33 in group B. No significant difference in implantation (11 % in group A and 14 % in group B, p = 0.81), clinical pregnancy (18 % in group A and 21 % in group B, p = 0.73) or live birth rates (13 % in group A and 18 % in group B, p = 0.53) was found. To conclude, no significant difference in reproductive outcomes was found when comparing patients with day 2 or overnight day 3 FET. Considering published data on blastocyst transfer, cleavage stage ET may still be a relevant option and the decision between day 2 or overnight day 3 ET depends on patients' and physicians' preference and recommendation.
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Affiliation(s)
- Chen Nahshon
- Division of Reproductive Endocrinology and IVF, Department of Obstetrics and Gynecology, Lady Davis Carmel Medical Center, Haifa, Israel; Ruth and Bruch Rappaport Faculty of Medicine, Technion - Israel Institute of Technology, Haifa, Israel.
| | - Martha Dirnfeld
- Division of Reproductive Endocrinology and IVF, Department of Obstetrics and Gynecology, Lady Davis Carmel Medical Center, Haifa, Israel; Ruth and Bruch Rappaport Faculty of Medicine, Technion - Israel Institute of Technology, Haifa, Israel
| | - Mara Koifman
- Division of Reproductive Endocrinology and IVF, Department of Obstetrics and Gynecology, Lady Davis Carmel Medical Center, Haifa, Israel; Ruth and Bruch Rappaport Faculty of Medicine, Technion - Israel Institute of Technology, Haifa, Israel
| | - Idit Blais
- Division of Reproductive Endocrinology and IVF, Department of Obstetrics and Gynecology, Lady Davis Carmel Medical Center, Haifa, Israel; Ruth and Bruch Rappaport Faculty of Medicine, Technion - Israel Institute of Technology, Haifa, Israel
| | - Shirly Lahav-Baratz
- Division of Reproductive Endocrinology and IVF, Department of Obstetrics and Gynecology, Lady Davis Carmel Medical Center, Haifa, Israel; Ruth and Bruch Rappaport Faculty of Medicine, Technion - Israel Institute of Technology, Haifa, Israel
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